| NPI | 1639767809 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BOBBY RICHARDS Business Owner 813-500-0734 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2021-01-04 |
| Last Update Date | 2021-01-04 |